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Medicine Crime

A Review of the "Mental Illness" Definition Might Prevent Crime 260

Posted by samzenpus
from the getting-it-right dept.
An anonymous reader writes "Following a BBC report showing abnormal variation in the number of people taken into police custody with mental health problems, concerns have been raised about the legal definition of "mental illness". Prof. Steve Fuller argues that a much sharper legal distinction is required to ensure criminals with mental disorders are not released without appropriate treatment. Fuller distinguishes between two cases: a 'client', who pays a therapist and enjoys a liberal, level-playing field in face-to-face interactions, and a 'patient' who is being treated by a doctor for a particular disorder. If the former relationship cannot be established due to person's mental state, then the latter one should be enforced. Thus, Fuller calls for 'a return to institutions analogous to the asylums of the early 19th century.'"
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A Review of the "Mental Illness" Definition Might Prevent Crime

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  • by Joe_Dragon (2206452) on Sunday December 01, 2013 @01:50PM (#45569149)

    Need more mental health centers not prisons with 23/7 lock down

    • by lgw (121541) on Sunday December 01, 2013 @01:56PM (#45569183) Journal

      Well, they easily serve the same purpose. How long until "disagreeing with the politics of the ruling party" becomes a mental illness? No, no, we're not locking up millions in prison camps, that would be fascism, we're just confining them in mental health institutions, it's really for their own good!

      • by squiggleslash (241428) on Sunday December 01, 2013 @02:31PM (#45569389) Homepage Journal

        How long until "disagreeing with the politics of the ruling party" becomes a mental illness?

        Probably in the same timeframe as "disagreeing with the politics of the ruling party" becoming a crime.

        Seriously, this is not a particular reason to object to "mental illness" definitions, any more than putting criminals in prison is a reason to object to laws. Any power can be abused. But some abusable powers are necessary. The question is whether you're willing, as an honest citizen, to be vigilant.

        • Ah, yes, Comrade! Those of us true to the Collective have always known that the Hooligans and Reactionaries had something wrong in their heads! Probably from a vodka deficiency or something.

          I, for one, welcome this! It's time we lock away all the dissidents until they learn to love Big Brother -- er, I mean, Dear Leader.

        • by Escogido (884359) on Sunday December 01, 2013 @02:57PM (#45569533)

          How long until "disagreeing with the politics of the ruling party" becomes a mental illness?

          Probably in the same timeframe as "disagreeing with the politics of the ruling party" becoming a crime.

          There is a good example - Russia has a long history of "diagnosing" dissenters with "mild schizophrenia" and similar mental conditions and "sentencing" them to be treated in special prison-like institutions. It started back in tsarist days in 19th century and lasted up until at least the late Soviet period, when a bunch of dissidents were forcefully "treated" from this. (There are also some reports it's been going on in the 90s but lately there have been no high profile cases.)

          Parallels can be drawn..

        • by Hatta (162192) on Sunday December 01, 2013 @03:20PM (#45569669) Journal

          We stopped being vigilant a long time ago. We stopped being honest citizens a long time ago. Many will sing the last line of our national anthem without a hint of irony, despite the fact that we imprison more people than any country in the world.

          The crimes we need to be afraid of are not the crimes committed by people behind bars. They are the crimes committed by men in suits, in government or corporate board rooms. Most people in prison are victims, either of unjust laws, or an economy deliberately engineered to work against the common man. We need to focus on the real problem. It's not the schizophrenics on the street corner, it's the sociopaths in DC and NYC.

          • by noh8rz10 (2716597) on Monday December 02, 2013 @12:21AM (#45572325)

            Most people in prison are victims, either of unjust laws, or an economy deliberately engineered to work against the common man.

            [citation needed] times infinity. this is an extraordinary claim that is false on its face.

            • Re: (Score:3, Informative)

              by Anonymous Coward

              At least on the federal level, it's trivial to prove (unless you're a shill for the War on Drugs):

              "The most serious charge against 51 percent of [federal prison] inmates is a drug offense. Only four percent are in for robbery and only one percent are in for homicide."

              (source [washingtonpost.com])

        • Re: (Score:3, Insightful)

          by Derec01 (1668942)

          No, because "protecting people" from their mental illness is a more sanitized, less outrageous aim, at least on the surface. If you're looking to stigmatize opposing points of view with a slow boil, it's an intermediate point. Just long enough to collect statistics "proving" that such people are often criminal, and regrettably must be incarcerated in some cases.

          Disclaimer: I don't believe in some large conspiracy attempting to do this. I am afraid that certain segments really believe this, though, and would

        • by Anonymous Coward on Sunday December 01, 2013 @10:54PM (#45572023)

          As somebody who had spent enforced two months in a mental ward after being conned into "self-admittance" (and later threatened with being shipped to a state institution unless I signed another set of papers claiming I committed myself voluntarily), I'd say the current system already needs rework.

          My family was told outright by one of the orderlies that because I had no insurance, I'd be kept for a while because that's they way the hospital gets money from the government (via Medicare).

          My "doctor" did everything possible to launch me into an anger spiral that would help them keep me locked up for a longer time. I was not the only one - I personally witnessed how they set up a young guy that came in through the emergency room after drunk drug overdose (at a party) - he did snap after being lied to and promised to be released on several occurrences (I witnessed two of those firsthand, being nearby - the place was that small), and when I finally fought my way out of there he had already been shipped to state "mental institution."

          From what I heard, that meant at least six months of being locked in.

          My "doctor" did nothing whatsoever to even pretend he cared for his patients. All were prescribed a cocktail of medications (with varying side effects), and that was it. No counseling, no sessions. My "welfare worker," the person supposedly assigned to protect the patients, was fully cooperating to keep me in (overheard their exchange waiting for the first and only "interview" I had with both of them).

          I got out because a member of my family knew somebody wealthy and connected enough to start causing problems for the "doctor" in charge. Otherwise I might as well have still been confined, for all I know.

          In the end, I declared bankruptcy rather than have them get around $34,000 of taxpayers' money for my "treatment." Consisting of involuntary confinement to a small shared room with two beds, two night-tables, a small bathroom, one corridor, and a TV room. If not for the books my family brought over, I'd probably go insane from boredom alone.

          I was merely an incidental victim. Somebody being thrown into that system on purpose would have even worse chances of getting out unscathed (if that's what I did). There was an article recently about New York policeman who ended up in a mental ward after speaking out about criminal behavior in his division.

          So, no. You are already there, it's just that few people realize it.

          • O'Connor v. Donaldson [wikipedia.org] was a landmark case in 1975 where the Supreme Court ruled that commitment to a mental institution is the same as imprisonment in a criminal penitentiary therefore the state has a burden of proof to prove to a Judge that the subject is a harm to society or himself and that there is no alternative, and consequently anyone subjected to being committed is entitled to legal representation.

            Even if you're voluntarily committed you should be able to leave at any time but if they force you to
      • by gtall (79522) on Sunday December 01, 2013 @03:27PM (#45569739)

        You do realize that until the 60's, the U.S. had a fair number of asylums. Then it was determined that the mentally ill had rights and they were promptly discharged with many finding the street life fit them better than anything else. It turned out the mentally ill had a right to be homeless.

        What is needed is a more sane approach to mental illness, especially now with so many vets suffering from PTSD. The discrimination should stop, but for that to stop people would need to be educated about mental illness....well, I guess the mentally ill are screwed then.

        The prisons are filled with people that simply run into the law enforcement system before they run into a mental health system. The law enforcement system cannot force one onto meds, so the poor souls get warehoused in the prisons. When they are let out, their neuroses are that much worse because mental illness frequently does not get better on its own. Left untreated, it gets worse. By that time, the mentally ill think of prison as a refuge, so they commit another crime to back.

        • Re: (Score:2, Insightful)

          by turgid (580780)

          Then it was determined that the mentally ill had rights and they were promptly discharged with many finding the street life fit them better than anything else. It turned out the mentally ill had a right to be homeless.

          The USA operates on a policy of Social Darwinism because anything else would be pinko-commie.

          If you're ill and or poor in the USA, the sacred Market will remove you from the human race if you are not sufficiently fit.

        • by Antique Geekmeister (740220) on Sunday December 01, 2013 @09:03PM (#45571625)

          Many of the asylums were horrible and without hope, due to longstanding medical orders for which there was no effective treatment. The advent of effective psychopharmacology changed that: people with bipolar depression, for example, devastating post-traumatic stress based depression,, devastating post-trautmatic stress, and numerous other problems became treatable and could be treated as outpatients or with short stays to stabilize their medication, then released. Care really did improve in the 1960's and early 1970's, when the psychoactive medications were better understood and seized upon with great joy by doctors and patients who'd before felt quite hopeless. Unfortunately, this became coupled with cost-saving "return to the community" programs and policies, and we wound up with _enormous_ numbers of ill people who could not safely live on their own, turned out without structure to remember to take their medication by themselves.

          The results have been predictable: numerous confused, somewhat insane people were left without the help they needed because their smaller, modern, fragmented families could not possibly fill in the gap of providing residential care. When coupled with the strain on the prison systems from the "war on drugs", the threshold for providing residential care has been raised so high that facilities willing to work with modest mental disorders have been overwhelmed by even more profound cases, an. And the quality of care for both has dropped, harshly.

          I'm afraid that I'm old enough to know relatives and colleagues with such members. When their need for treatment leads them to self-medicate with illegal drugs, they then wind up snared in the "war on drugs" and "zero tolerance" policies, and become even more difficult to help.

          • by Rich0 (548339)

            Well, when you think about it what causes people to be in prison are behavior problems, and the reason that mental problems are, well, problems, is because they tend to cause behavior problems.

            I think that better treatment for mental problems is part of the solution. Most people in the US have health plans that don't cover much treatment for mental problems. If you see a psychiatrist chances are that you're going to pay more out of pocket, and be limited to so many visits/etc. If you're an airline pilot

      • by Chalnoth (1334923)

        The point is that we should be focusing on treatment, not punishment. There's also the extremely problematic aspect that people with mental illnesses may be less-able to defend themselves in court.

        My primary concern with the way this was stated, however, is that many poorer people won't have access to mental health treatment, so they may be treated in the court system as if they have no mental illness. That is a serious problem. Honestly, I think we should just decide that medical treatment (whether ment

      • by Mashiki (184564) <mashiki@NOspAM.gmail.com> on Sunday December 01, 2013 @03:54PM (#45569871) Homepage

        Well, they easily serve the same purpose. How long until "disagreeing with the politics of the ruling party" becomes a mental illness?

        Considering during the 5ish years there's been a slew of attacks on people who "don't fit their world view" including pseudoscience like papers? It's already happening, funny thing about that most of them are attacks on conservatives or the tea party. Though there have been a few on liberals as well, all in all? It's exactly what every dictatorship does, you don't have to search far to find it.

      • No, no, we're not locking up millions in prison camps, that would be fascism

        That would be any oppressive totalitarian regime. The ideology is just the window-dressing necessary for getting into power.

      • That'd be fine with me. Fuck man, we're all trying to live a nice life whereby we can figure out what all this life stuff is about anyway, right? And so much money we currently have to gain in order to just pay simple bills, we get stuck working the whole time we're alive, wasting our lives away, simply trying to keep from being homeless.

        If the government is willing to pony up the dollars to support the entire "crazy population" (and again, crazy because they don't agree with politicians) then I'll be
      • by gallondr00nk (868673) on Sunday December 01, 2013 @04:53PM (#45570219)

        How long until "disagreeing with the politics of the ruling party" becomes a mental illness?

        Perhaps, but more likely is how long before we start lowering the threshold for which someone requires "help". Especially if the facilities were private, which is 99% certain these days.

        In 2008 in Pennsylvania two judges were convicted of accepting bribes from Robert Mericle, who owned private youth detention facilities. In return, they would sentence kids to incarceration in his facilities for such heinous crimes as shoplifting a DVD from Wal-Mart, trespassing, or in one case making a video on Myspace mocking the principle of a school.

        Considering that mental health is so subjective and still poorly understood, could you imagine the amount of abuse that would occur? I would measure in seconds the time between such a facility opening and doctors being bribed to incarcerate patients, "for their own good".

        This is a problem which has become endemic in private prisons. When it becomes profitable to incarcerate someone, the last real barrier to simply incarcerating anyone deemed undesirable is removed.

        It has been long argued that drug laws in the US are mainly only used to convict unemployed, poor and predominantly black men in large cities, for whom there are few prospects and no jobs. With meth, this has extended to white people in the same position, in the same way opium laws did to the Chinese in the past.

        How long before a new system of mental health facilities serve precisely the same purpose?

        • by DarkOx (621550)

          Considering that mental health is so subjective and still poorly understood, could you imagine the amount of abuse that would occur? I would measure in seconds the time between such a facility opening and doctors being bribed to incarcerate patients, "for their own good".

          We don't need imagine, there is plenty of evidence that there was a great deal of abuse where the old system of institutionalization was concerned. That is one of the reasons society decided to dismantle that system in the 60's. This was the height of the "great society" after all its not as if the objection to the state "caring" for the mentally ill was on anit-socialwelfare spending grounds.

        • by Ol Olsoc (1175323)

          How long until "disagreeing with the politics of the ruling party" becomes a mental illness?

          Perhaps, but more likely is how long before we start lowering the threshold for which someone requires "help". Especially if the facilities were private, which is 99% certain these days.

          In 2008 in Pennsylvania two judges were convicted of accepting bribes from Robert Mericle, who owned private youth detention facilities. In return, they would sentence kids to incarceration in his facilities

          The invisible hand of the free market in action! Too bad anyone who claims to see said hand will be declared insane.

          But the concern is real. The underlying evil in for profit prisons and for profit mental incarceration is that a publicly held corporation must show increased profit on a regular basis.

          The only way to increase profit is to either lower costs or increase the people who are the "product", so that the customer pays more.

          There are finite limits to decreasing costs. There is already a large p

      • by ultranova (717540)

        No, no, we're not locking up millions in prison camps, that would be fascism,

        Admitting that you have a problem [wikipedia.org] is the first step to recovery.

        we're just confining them in mental health institutions, it's really for their own good!

        Does the US actually need such excuses? I was under the impression that "tough on crime" was a fad nowadays, so you could probably get more political points by stressing how bad they have it in "pound-me-in-the-ass" prisons. And those attitudes are unlikely to soften since economy

    • Re: (Score:3, Insightful)

      by Anonymous Coward

      Some mental health centers can be compared to prisons, with similar lock downs. Once admitted to a mental health facitlity, it can be harder to get out of than prison. And, depending on your location and health insurance coverage, they can be very easy to get stuck in.

    • by AlphaWolf_HK (692722) on Sunday December 01, 2013 @01:59PM (#45569207)

      The trouble with mental health is that there isn't any kind of magic bullet treatment like there can be with just about any other disease.

      Usually the best treatments come from medication, and if the person stops taking their medication (this is very often the case, they think they don't need it anymore, especially due to the stigma attached to it which often makes them WANT to stop taking it) then they go back to how they were before, only this time going back on the medication doesn't solve the problem and the psychologist has to keep trying different medications until one works, assuming they can ever find one.

      Or they can also come from therapy (depends on the exact condition) and if you keep them in these places until they are "treated", it may as well be a prison sentence. I've seen these places, they very much remind me of a prison: The windows are barred, the doors are all locked and only visitors and/or staff are allowed through them, and visitors can't bring plastic or metal inside. The patients are forced to sit around doing nothing all day long, maybe get to play backgammon with some derp who was born without a personality, or if they're lucky he'll be a nut and somewhat entertaining to talk to.

      • by ceoyoyo (59147) on Sunday December 01, 2013 @02:16PM (#45569319)

        "The trouble with mental health is that there isn't any kind of magic bullet treatment like there can be with just about any other disease."

        There's almost never a magic bullet treatment, for any disease, mental or physical. The problem with mental illness is that it diminishes the sufferer's ability to make decisions for himself. That doesn't mesh well with a society of individuals.

        • by TemperedAlchemist (2045966) on Sunday December 01, 2013 @02:25PM (#45569363)

          It's exacerbated by a society that doesn't take it seriously.

          No, really, no one takes the fact you have a mental illness seriously until you do something completely batshit crazy like shoot up a school. If I had a nickel for every time someone told me I didn't have a reason to feel depressed...

          You are ignored, basically, until you commit a crime. THEN people care. Until then you're not ill, you're just a lazy loafer.

          • by sjames (1099)

            You are ignored, basically, until you commit a crime. THEN people care. Until then you're not ill, you're just a lazy loafer.

            And after, you're a dangerous criminal who must be punished.

        • and so does the treatment.

          having someone declared mentally ill was a good way of getting rid of them back in the 19th century.
        • But we are in general, much more successful in treatment of 'physical' conditions rather than 'mental' (See what I did there? I artificially made a distinction where there really isn't one.) With some of the new techniques and knowledge in neurobiology we are getting closer (although this has been said many times before).

          The problem then becomes do you really want to go there? It is easy to imagine a period of time in the not to distant future when medical science understands cognition and emotion well e

        • by pla (258480) on Sunday December 01, 2013 @03:11PM (#45569623) Journal
          There's almost never a magic bullet treatment, for any disease, mental or physical.

          I have to disagree... If I get strep or pneumonia, they give me a z-pack and bam, it magically goes away. If I have a broken finger, they give me vicodin and bam, I magically don't care about the pain (though yes, the finger itself just takes time to heal). If I have insomnia, they give me ambien and bam, I can magically sleep again. When my knees or hips eventually wear out, they give me new ones and bam, I magically get to walk for another 20-30 years. And keep in mind that many of our "magic bullets" work on a larger scale and longer term scale - Vaccination, water sterilization, sewage treatment, annual physicals, etc.

          Even for the things that still tend to kill us, like cancer and heart disease, we have a lot of magic bullets that let us live far, far longer than we would have a century ago. Case in point, we wouldn't have various religiots arguing over their "right" to murder (as in the case from last week) their 10YO daughter by refusing treatment for a 95% survivable form of leukemia. She would simply have died, no moral issues involved.

          But for mental diseases, it gets a lot messier. There, I would have to at least partially agree with you. We have plenty of ammo, but precious few we would dare call "magically" effective. Perhaps more like "napalm", where they might get the job done, but with so much collateral damage that you have people going off their meds because the cure sucks almost as much as the symptoms (to give my metaphors a good stir there).

          Perhaps more to the point of TFA, I would have to agree with its author. We need to get over this societal PC BS that every sociopath and drooler can, with the right care, grow up and lead a productive life as a rocket surgeon. Some people will never manage more than wiping their own ass, and some people will never grasp why they can't "earn" their living pointing a gun at convenience store clerks. Simple as that. Best for us, and best for them, to keep them off the streets until such time as we can cure "criminal" with a magic bullet - Preferably starting the process before they take a real bullet from an armed victim or a cop or a partner crossed.
          • Great response (Score:2, Informative)

            by Okian Warrior (537106)

            I have to disagree... If I get strep or pneumonia, they give me a z-pack and bam, it magically goes away. If I have a broken finger, they give me vicodin and bam, I magically don't care about the pain (though yes, the finger itself just takes time to heal). If I have insomnia, they give me ambien and bam, I can magically sleep again. When my knees or hips eventually wear out, they give me new ones and bam, I magically get to walk for another 20-30 years. And keep in mind that many of our "magic bullets" work on a larger scale and longer term scale - Vaccination, water sterilization, sewage treatment, annual physicals, etc.

            Wow - great response. Thanks for that!

      • Wow I'm modded troll for talking frankly about mental health. I guess that kind of goes to show you just how seriously we take it at least. Even talking about it lands you scorn.

        I have experience with it because two of my relatives have been through it (I have literally more than 50 first cousins btw, or at least that's where I stopped counting, and I don't need to talk about probabilities) and it's pretty damn stupid how the system works, at least in the states anyways.

        • by davydagger (2566757) on Sunday December 01, 2013 @03:03PM (#45569571)
          this isn't about mental health.

          This is about false diagnosis used as a shadow justice system for malcontents, and bringing back torture and abuse.

          we're not talking about people who actually need help. we are talking about people who are about to be rammed through the system because the system wants them gone, without too much of a fuss if they were ordinary criminals
        • There is this psychiatric issue called transference [wikipedia.org]. (In this case the third definition) that may be operative here. I sometimes wonder exactly what kind of childhood the majority of Slashdot moderators had. Kinda scary.

      • The trouble with mental health is that there isn't any kind of magic bullet treatment like there can be with just about any other disease.

        Pulling those people out of poverty should help a lot (as it does with a lot of illnesses).

    • Re: (Score:2, Insightful)

      by Anonymous Coward

      Right. Just put half of the population either into mental health centers or in prisons.

      That will save you from thinking about why you've got so many criminals and people who are nuts.

    • by davydagger (2566757) on Sunday December 01, 2013 @02:59PM (#45569543)
      I think you misunderstand.

      mental health centers ARE prisons.

      They are calling for a return of the bad old days of 19th century asylums.
  • The problem is... (Score:5, Insightful)

    by TWX (665546) on Sunday December 01, 2013 @01:54PM (#45569171)
    ...who decides. We've all exhibited behavior at one time or another that could be interpreted as antisocial, and with our paycheck-to-paycheck lifestyle and less institutional family connections, it's very possible that someone involuntarily committed may find literally all of their worldly possessions gone when they come out. Such involuntary confinement could be used when someone in authority finds something otherwise noncriminal to be abhorrent. There are numerous examples of countercultures throughout our fairly recent history that were investigated by the authorities, and it was bad enough without those people having to particularly worry about involuntary confinement attributed to supposed mental illness.

    Who decides, what they can compel, and how that person's life is managed while they're institutionalized are all very, very important factors in if it's even possible to use involuntary medical-based confinement or not.

    And that doesn't even begin to address costs. While I don't care for it, it's possible for prisons to get some return on their costs by using prison labor to do things that don't really pay the prisoners but do pay the prison. If someone's committed for what's supposed to be a mental illness problem, it's doubtful that using that person for profit for the institution would really be possible.
    • Generally, society gives a free pass to antisocial / psychopathic behavior until and unless it passes some artificial boundary. That boundary is flexible and varies from place to place and time to time. In our present culture, pyschopathic tendencies are in fact generously rewarded in many instances (politics, business) and it actually takes a serious transgression (axe murderer) to get nailed.

      Of course, the big problem here is that personality disorders and actual mental illnesses exist along a complex,

    • by Hentes (2461350)

      According to RTFA, the courts would decide. The guy is talking about convicted criminals.

      • by DarkOx (621550)

        First you get "convicted" of running a stop sign, then a judge orders a psychiatric evaluation where its determined you need to be locked away indefinitely without appeal.

        The system was abused before and certainly would be again now more than ever in fact. In days gone by people just did not go poking the noses about and asking questions. These days eve if someone sees blatant abuse staring them in the face they won't speak out and why would they given how we treat whistle blowers.

    • There are numerous examples of countercultures throughout our fairly recent history that were investigated by the authorities, and it was bad enough without those people having to particularly worry about involuntary confinement attributed to supposed mental illness.

      I think this is the big problem. Lots of people imagine asylums being used to lock up political opponents, but that's not terrifically likely in a way that I would worry about. In short, if one political party has enough power to simply lock up political opponents, then they're going to do that somehow or another. Issues of cost, as well as issues of whether the system would actually benefit the mentally ill, are less of a fundamental concern-- they're both bound up in how well the system is executed rat

  • by Anonymous Coward

    It is my understanding that you get punished once for being a criminal. With a so called diagnosis associated with you for whatever reason, sensible or not, that type of personal information probably be used against you for life.

  • Foundation question (Score:5, Interesting)

    by Okian Warrior (537106) on Sunday December 01, 2013 @02:04PM (#45569235) Homepage Journal

    Apropos of nothing, let me ask a question.

    Can people be cured of mental health problems?

    I recall a study comparing the rates of people getting off drugs while on psychotherapy with those getting off drugs on their own.

    I also recall a study where completely sane people were checked into a mental institution (under a false name, as a test case) with instructions to pretend symptoms for awhile, but then pretend to be completely cured. Their status was never set to "cured", rather it was "condition, under remission".

    So have there been any studies showing that mental health treatment is effective, or is psychotherapy more akin to lie detectors and phrenology?

    (A related question, is there good sensitivity between the various mental health diagnoses with different treatments? Meaning, if the condition A treatment is different from condition B, is there a sharp, easily-recognized distinction between the symptoms for A and B?)

    • by swillden (191260) <shawn-ds@willden.org> on Sunday December 01, 2013 @02:43PM (#45569457) Homepage Journal

      I, unfortunately, have had far too much exposure to the mental health system, due to mental illness in my immediate family. I'll give you my perspective on your questions, based primarily on my anecdotal experience, plus some research-based discussions with practitioners.

      I think the answer is a qualified yes, people can be made better, though "cured" may be too strong.

      Mental health treatment is, I think, much where medicine was shortly after the discovery of the germ theory of disease. It's beginning to become a capable, scientific endeavor, and it is very useful within the areas that it works, but there's lots we don't understand, about what goes wrong, about why it goes wrong, about what will and won't work to fix it, and even about why the stuff that does work, works.

      My daughter's condition is a good example. She has Borderline Personality Disorder (which is a really terrible, inaccurate name, and everyone knows it, but that's the label that got stuck on it). There is no cure but time; most BPD sufferers eventually achieve fairly normal functioning by their mid 30s. There are some treatments that help, though. Sometimes. The best one is a particular form of psychotherapy called Dialectical Behavioral Therapy, which is at root mindfulness training. It's effectiveness is definitely better than nothing, but whether or not it will help a person become a functional member of society is very hit or miss. My daughter's doing okay, but has real challenges.

      My sister's son, on the other hand, has Bipolar Disorder. There are great meds that almost completely fix the problem for a large percentage of sufferers, including him. In addition, it appears that specific dietary restrictions can do just as much as the meds. I understand that schizophrenia is eminently treatable with medication, though the severe side effects often discourage its use.

      I have ADD, and so do all three of my sons. There are very effective medications for it, but there are also learned habits that can be used to work around it. My older sons and I use the latter plus a little self-medication with caffeine. My youngest takes Concerta.

      Depending on the disorder, sometime diagnoses are clear and incontrovertible, and proof of "cure" (or management) is equally incontrovertible. Sometimes it's really fuzzy. Sometimes treatment is effective and well-understood. Sometimes it isn't.

      The answer, I think, is to be very clear about what we can and cannot do, and to do what we can. And, of course, to continue research into improving our ability to understand and treat.

    • Re: (Score:3, Informative)

      by Justarius (305126)

      There's a base assumption at play here that makes the addressing the issue at hand much more murkier than it should be.

      Psychiatry sees all mental health problems as, in root, organic in nature. In other words, there is a chemical imbalance, a brain trauma, or a genetic component that creates the symptoms. These mental health issues can be seen as "cured" through medical regimes, but, many other illnesses, considered under remission, since a chemical imbalance caused by a genetic component cannot be "cured".

  • by Kaenneth (82978) on Sunday December 01, 2013 @02:06PM (#45569249) Homepage Journal

    I've read that statistically, schizophrenics are more likely to be victims of violence, from people who misunderstand their behavior (stand your ground *cough*) than to commit violence...

    So, who should be locked up?

    (too early in the damn morning to try and look up a cite.)

    • by Anonymous Coward on Sunday December 01, 2013 @03:42PM (#45569811)

      I'm a schizophrenic who has repeatedly been a victim of violence. However, as far as I know, it has nothing to do with people not understanding my behavior, and more to do with the situations I've gotten myself into, such as mental hospitals and group homes. It's been my observation that most of the people who work in those types of places want to help, but some see it as a means to exert power, sometimes violent, over others and get away with it.

  • by erroneus (253617) on Sunday December 01, 2013 @02:09PM (#45569279) Homepage

    Are we responsible for the crimes we commit? If we are mentally ill, then surely we're not responsible. And if we're not responsible, then surely we need to have another "protected class" of people defined to prevent harassment, discrimination and unjust punishment. What they are attempting to do is reduce and even remove freedoms and rights which are both natural and constitutionally guaranteed. I'm not going to say that mentally unstable people should have access to dangerous things such as cars, knives, heavy bludgeoning devices and especially not firearms. If someone is indeed a "danger to society" we need to be serious about it -- very serious and very consistent. To deny someone their rights such as the right to self defense while at the same time not affording them appropriate protections under the law to compensate creates an extremely unfair situation.

    • by Reziac (43301) *

      I've known people who were mentally ill, but completely aware of right vs wrong. Whether they'd DO wrong depended on how they saw it impacting themselves.

      • by erroneus (253617)

        Knowing if something is right or wrong at the right time is key and is truly the issue with impulse control disorders. Typically this arises in no small part due to prioritization of feelings versus facts. Rage is a feeling. Perceived danger is a fact. One of these situation may call for the use of a firearm while the other does not. So which sort of mental disorder is also a matter which warrants scrutiny.

        What you describe is someone making a reasoned decision of some sort. And you know, by that defi

    • Good response, brilliant insight. Thanks for that!

  • Wouldn't this open the door to the government having people institutionalized simply because they're politically inconvenient? Say, someone is arrested for taking part in a political protest, are "diagnosed" as having some sort of vague mental disorder, refuses "counseling" to "cure" the condition, and is then compelled to "treatment" for it, effectively imprisoning them, medicating them, until they change their opinions? Isn't this the same shit that happens all the time in China to citizens merely demandi
  • In other news (Score:4, Informative)

    by echnaton192 (1118591) on Sunday December 01, 2013 @02:15PM (#45569315)

    I do not think that having mental problems in Great Britain is a good idea: http://www.dailymail.co.uk/news/article-2516270/Pregnant-woman-unborn-baby-girl-forcibly-removed-caesarean-social-workers-obtain-court-order-suffered-mental-breakdown.html [dailymail.co.uk]

    They've sent her to the hospital, drugged her, cut her baby out of her and gave away the baby of this italian mother for adoption in the UK because even though she is on medication and made a full recovery she might one day have mental problems again. The baby will not even grow up in italy.

    Just wow.

    • That is pretty "wow" but suffering a nervous breakdown and having bipolar disorder are not necessarily the same thing. I feel for her but I wonder if there is more to the story than what was reported. Did she try to commit suicide during her breakdown or otherwise injure herself or the fetus? Either way, a C-section without consent is a huge deal and I hope she sues and wins.
  • by Kohath (38547) on Sunday December 01, 2013 @02:20PM (#45569341)

    "Preventing" crimes is not justice. Locking up innocents to "prevent" them from committing crimes is essentially the opposite of justice.

    Also, note what they're preventing: "crimes". Not violence or any action that harms anyone. "Crimes" encompasses all manner of disobedience toward authority, regardless of whether that authority is legitimate. Example: Man faces felony charge over trimming shrubs [utsandiego.com]. Not a crime: DEA locks up a student, forgets about him for 4 days with no food or water [nydailynews.com].

  • I'd agree if the old Asylum system hadn't be abused in such horrific ways in the past. The exact same thing would happen again. I think the one thing we've learned from our current system is that people with mental illness can usually lead happy productive lives. There's even growing evidence that the "voices" schizophrenics hear are actually beneficial for them (their psyche is trying to express itself) and our forced treatment and mistreatment of those afflicted does far more harm than good. We need to fi

  • by khb (266593) on Sunday December 01, 2013 @03:34PM (#45569775)

    I know, on /. we don't need to. But it seems to me that the point that the Fuller appears to be making is that the current environment (presumably in the UK where he practices) is that a very large number of people are diagnosed with "mental illness" which is fine if they are continuing to be largely functional, seeing a therapist of their choosing, etc. The problem is that when someone is arrested the question of "mental illness" has two different dimensions ... is the person legally responsible for their actions (the legal dimension) vs. is the person undergoing treatment (or has ever undergone treatment).

    People who are not responsible for their actions are a tiny minority. But IF someone has been identified as not responsible for their actions, why are they left roaming the streets? That isn't fair to them or to society.

    Admittedly, there is always the question of "who is to say" and that begs the question to appropriate due process (clearly, it shouldn't just be some random doctor or family member has nominated them for commitment). And clearly there were abuses in the past. I don't think Fuller is the first to notice that the current situation is arguably worse (fraction of homeless people who are seriously ill ... of course, that begs the question of whether their mental condition caused the homelessness or the other way around :).

    I'm far from sure that I agree with Fuller, but the vast majority of the comments seem to be missing his core argument.

  • medical model (Score:4, Insightful)

    by John Allsup (987) <<moc.liamg> <ta> <euqsilahc.s>> on Sunday December 01, 2013 @03:35PM (#45569779) Homepage Journal
    the problem is that the medical model is nowhere effective at understanding, diagnosing and treating mental disorders as the physical medicine disciplines.  already many people get diagnosed and forced onto a drug therapy route, which doesn't treat the disorder, inhibits their learning, awareness and motivation to the point that they become unable to seek out effective avenues, and the psychiatrists just up or change the drugs and ignore their ineffectiveness.  people get trapped in a life of legally enforced drug dependence that benefits only pharmaceutical companies.  people who make suggestions like in the article believe that the medical model and standard therapies are more effective than they are.  people will.get unwell, forced to take treatments that don't work for the rest of their lives, and just be a drain on the taxpayer, being unable to work, and being able to do little other than blowing their state benefits on tobacco and alcohol.  the people who make such suggestions have no experience of actually being a mental patient, nor how ineffective typical medical treatment is.  this is the unfortunate reality of mental health, where successful recovery happens in spite of the system, not because of it, and successful methods that are not profitable to pharmaceutical giants are seriously underfunded even when reported in the literature.  end rant.  sent from a mobile, so apologies for typos.
  • by dixonpete (1267776) on Sunday December 01, 2013 @03:42PM (#45569813)
    I spent 25 years in the mental health system regarded as a seriously bipolar person. Turns out it was caffeine and to a lesser extent chocolate and a host of medicines that was causing the effect. I've been 5.5 years now symptom free. Never forget to eliminate environmental causes for mental and physical health issues!
  • Just because you get arrested and taken to the police station does NOT make you a criminal. Being convicted of a crime is what makes you a criminal. So far the summary is just plain wrong and makes me wonder if the article is any better.

    The police arrest a lot of people that they end up letting go, whether or not charges are brought up against them later. None of those people are criminals, unless they have been previously convicted of a crime.

    • by Nyder (754090)

      okay, either I am seeing shit, or someone fixed that shit, because the summary say nothing about criminals.

      fuck, maybe i should go back to bed.

  • by Anonymous Coward on Sunday December 01, 2013 @04:11PM (#45569979)

    As someone with major mental illness who also spent time in gaol for a heinous crime, this is a terribly thorny issue. Due to the trend of "community based care", many patients stuff up their meds, and so end up committing crimes. As there is a lack of proper care facilities, we end up incarcerated in prison. This is a hell of a scary place for anyone, let alone someone with mental illness. Prison Mental Health is a joke, as it concentrates on the use of Seroquel for behaviour management, and there is absolutely no focus on life skills or therapy. Furthemore, prison officers are not mental health nurses, yet in the facility I was incarcerated in, about 2/3 of inmates were on psych meds.

    In many respects, the old 19th century model of asylums (i.e. secured hospitals) could well be a better way to reduce recidivism, and to help patients learn to manage their disease and life. Prison certainly doesn't help - I came out more unstable than when I went in, as well as being traumatised by the rapes, stabbings and suicides.

    Yes, prison is a consequence of action, but for those who commit a crime when unwell, but fail the test for diminished responsibility (it can be hard to prove you didn't know you were doing wrong, let alone deal with how you might know that society/law judges your actions wrong, but due to delusional thinking you think you're justified in your actions) it usually only makes things much worse. Hence the suicide rate in prison and amongst parolees.

    • I've been saying for some time that asylums would be a good way to help some people.

      Case in point: a neighbour of mine is so damaged that he won't ever be able to properly take care of himself. Even with some sort of future tech that could switch off his schizophrenia, he is still so damaged that he'd never be able to feed or wash himself properly. He is terribly depressed due to loneliness, which has him bring home people who are not particularly pleasant. The trouble he brings home is often cause for p

  • They are called Banks

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